Blake Nelson Jordan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1784 Uinta Way Ste E
Park City, UT 84098-7669

Phone

(435) 604-0160

NPI assigned

Nov 4, 2025

Last updated

Nov 4, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stat MD LLCGroup PAC ID 7719295716, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blake.jordan.2@13853.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stat MD LLC

  • Urgent Care Clinic/Center
  • Park City, UT
  • NPI 1225411473
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1740159060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 S 30 E",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "846535305",
            "telephone_number": "435-227-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 UINTA WAY STE E",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840987669",
            "telephone_number": "435-604-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "BLAKE",
        "middle_name": "NELSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Vargas Johnson, ATC
• Kent Max Johnson, DDS
• Norma Elizabeth Johnson, MS ATC
• Troy Johnson, PA.C
• Mardee Jones, NP
• Britta Rajamaki Joslyn, M.S., CCC-SLP
• Kate Roma Belarga Josue
• Brandon Judd, MPT
• Jupiter Medical I LLC
• Michael Aaron Kagen, M.D.

• Medical Physician Assistant in Park City, UT
• Providers in Park City, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.